Why do super-fit runners sometimes have heart plaque?
Coronary Atherosclerosis in Masters Athletes: Mechanisms and Implications for Cardiovascular Disease Risk
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Some older athletes have plaque in their heart arteries, but it's usually hard and stable — not the kind that breaks and causes heart attacks. Even with plaque, they don't die more often from heart problems, probably because they're so fit.
No biological mechanisms were identified in this study. This may be an epidemiological, observational, or survey-based study that reports associations rather than proposing causal biological pathways.
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Evidence Score
Based on clinical experience or non-systematic literature reviews. The lowest level of evidence as they are most susceptible to bias and personal perspective.
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Some older athletes have plaque in their heart arteries, but it's usually hard and stable — not the kind that breaks and causes heart attacks. Even with plaque, they don't die more often from heart problems, probably because they're so fit.
No biological mechanisms were identified in this study. This may be an epidemiological, observational, or survey-based study that reports associations rather than proposing causal biological pathways.
Systematic Reviews & Meta-Analyses
Max 100Randomized Controlled Trials
Max 90Cohort Studies
Max 72Case-Control Studies
Max 58Cross-Sectional Studies
Max 44Case Reports & Case Series
Max 30Expert Opinion & Narrative Reviews
Max 51 / 5
Evidence Score
Based on clinical experience or non-systematic literature reviews. The lowest level of evidence as they are most susceptible to bias and personal perspective.
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Claims (6)
Even if you’re super fit, if you have hidden heart artery disease, doing something really intense — like a marathon — can suddenly trigger a heart attack or cardiac arrest.
Older athletes who train hard for many years tend to have more calcium deposits and fatty buildups in their heart arteries, but these buildups are usually hard and stable, not soft and dangerous.
Even though athletes have more plaque, it’s usually hard and chalky, not soft and gooey — so it’s less likely to suddenly break off and cause a heart attack.
If an athlete has a high calcium score on a heart scan (over 100), doctors should treat them like someone with early heart disease — lower their bad cholesterol and test how their heart handles exercise.
Even though super-fit people have more calcium in their heart arteries, they still live longer and have fewer heart attacks — their fitness seems to protect them from the danger of the plaque.